Refractory Idiopathic Thrombocytopenic Purpura Treated with Azathioprine

OUR results in the treatment of idiopathic thrombocytopenic purpura with splenectomy and corticosteroids have previously been reported. In our overall, long-term, evaluation of 271 patients with idiopathic thrombocytopenic purpura 7.7 per cent failed to respond to either method of therapy, and 4.4 per cent subsequently died from fatal bleeding.1 Over the past six years there has been an increasing interest in the suppression of the immune response by antimetabolites.2 3 4 5 6 7 8 9 10 Schwartz and Dameshek11 first reported their encouraging results in the treatment of autoimmune hemolytic anemia with 6-mercaptopurine or thioguanine.Azathioprine, 6-(1-methyl-4-nitro-5-imidazolyl)-thiopurine, B.W. 57–322, developed in recent years, is related to 6-mercaptopurine . . .